| 97066-5 | Acute ill w/fever | |
| 97067-3 | Aller react 1st COVID-19 dose | |
| 97068-1 | Hx chronic diseases/immunodeficiency | |
| 11339-9 | Hx of Major illnesses and injuries | |
| 82757-6 | Immunodef | |
| 97069-9 | Hx coag disorder &/or bld-thin med | |
| 45675-6 | Allergies | |
| 8658-7 | Hx of Allergies | |
| 97070-7 | AE p vaccine | |
| 30948-4 | Vaccination AE | |
| 97071-5 | Pregnant/Nursing | |
| 97072-3 | Vacc last 14 D | |
| 97073-1 | Rcvd COVID-19 vaccine | |
| 30952-6 | Date+time of vaccination | |
| 30957-5 | Manufacturer name Vaccine | |
| 97065-7 | Hx for COVID -19 vaccine | |